Wage Verification Form for Employment and Income Details
The Wage Verification Form is used by the Lee County Department of Social Services to verify employment details for social services applicants. Employers must fill out this form to provide essential information about the applicant's employment status and income. Complete the form to ensure a smooth application process for social services.
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How do I fill this out?
To fill out this form, begin by providing your company's information. Next, answer the questions regarding the employee's current employment status and income details. Be sure to provide accurate past pay information and any termination details if applicable.

How to fill out the Wage Verification Form for Employment and Income Details?
1
Provide your company name and contact information.
2
Indicate whether the individual is currently employed.
3
Fill in the employment dates and pay details.
4
Answer questions regarding benefits such as childcare assistance.
5
Sign and date the form before submitting.
Who needs the Wage Verification Form for Employment and Income Details?
1
Employers need this form to verify employment for their employees applying for assistance.
2
Social services caseworkers require this form to assess applicants' eligibility for programs.
3
Childcare providers may need this form to determine subsidy eligibility for parents.
4
Financial institutions may request this form for loan applications relating to self-employed individuals.
5
Individuals applying for unemployment benefits must submit this form to validate their previous employment.
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What are the instructions for submitting this form?
To submit the Wage Verification Form, you can fax it to the Lee County Department of Social Services at (919) 718-4634. Alternatively, mail it to P.O. Box 1066, Sanford, NC 27331. For any questions, contact a child care subsidy caseworker directly at (919) 718-4690 for assistance.
What are the important dates for this form in 2024 and 2025?
Important dates regarding the Wage Verification Form vary annually. It's recommended to check for any updates each year for changes in requirements. Ensure all submissions are made timely to avoid delays in assistance.

What is the purpose of this form?
The Wage Verification Form is designed to facilitate the verification of employment and income for individuals seeking social services. By collecting accurate employment details, social service departments can determine eligibility for various assistance programs. This form is essential for employers to confirm employee details and for applicants to receive the necessary support.

Tell me about this form and its components and fields line-by-line.

- 1. Employer Information: Includes company name, address, and contact details.
- 2. Employee Status: Indicates whether the individual is currently employed.
- 3. Employment Dates: The starting date of employment and any termination dates.
- 4. Income Details: Information about pay received, frequency of pay, and potential childcare assistance.
- 5. Termination Information: Details regarding the reason for job termination if applicable.
What happens if I fail to submit this form?
Failure to submit the Wage Verification Form can result in delays in processing social service applications. Without this form, caseworkers may be unable to verify employment and income accurately. It is crucial for the timely processing of applications.
- Delays in Application Processing: Inability to verify income might lead to longer wait times for assistance.
- Ineligibility for Benefits: Incomplete forms could result in applicants not receiving necessary support.
- Additional Follow-Up Needed: Caseworkers may need to reach out for more information, causing further delays.
How do I know when to use this form?

- 1. For Social Services Applications: Use this form to support applications for various social service benefits.
- 2. For Employment Verification: Employers fill it out to provide accurate verification of employee status.
- 3. For Childcare Subsidies: Necessary for confirming eligibility for childcare financial assistance programs.
Frequently Asked Questions
How do I access the Wage Verification Form?
You can easily find and access the form on our website's document section.
Can I edit the PDF after downloading it?
Yes, you can edit the PDF using PrintFriendly's PDF editor before downloading.
What information is required to fill out this form?
You will need the employee's employment status, pay information, and company details.
Is there a way to sign the form digitally?
Absolutely, you can add your digital signature directly on PrintFriendly.
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You can edit and download your documents, though saving on our site is currently not available.
Does the form need to be notarized?
No, notarization is not required for this form; it only requires a signature.
How long will it take to fill out the form?
Filling out the form should take about 10-15 minutes, depending on the complexity of the employment details.
Who can assist me if I have questions regarding the form?
You can contact the child care subsidy caseworker for any specific questions or clarifications.
What happens if I provide inaccurate information?
Providing inaccurate information may delay the processing of social service applications.
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